Clinical benefits and future directions of medium cut-off membranes in hemodialysis: a comprehensive review.

Medium cut-off (MCO) membranes have emerged as a promising innovation in hemodialysis (HD), offering enhanced clearance of large middle-molecules of uremic toxins compared to traditional HD membranes, while maintaining minimal loss of albumin. The introduction of MCO membranes represents a significant advancement in dialysis technology, potentially reducing the risk of complications associated with inadequate removal of toxins. Compared to high-flux membranes, MCO membranes demonstrate superior efficacy in eliminating large middle-molecules without excessive loss of beneficial proteins, such as albumin. The clinical benefits of MCO membranes extend beyond toxin clearance. They improve quality of life, reduce erythropoiesis-stimulating agent doses and resistance, lower hospitalization rates, and decrease overall healthcare costs. Currently, there is insufficient evidence regarding the effects of MCO membranes on cardiovascular diseases and mortality. Further studies are required to assess their effects on patient outcomes and long-term survival. Future innovations in membrane technology, coupled with ongoing research and development, have the potential to enhance dialysis efficacy further, reduce complications, and facilitate the development of eco-friendly solutions. Additional studies are required to fully explore the potential of MCO membranes and refine their clinical application.